Proposed Decision Memo for Screening for the Human Immunodeficiency Virus (HIV) Infection (CAG-00409R)

CMS is proposing to expand coverage in section 210.7 of the Medicare National Coverage Determinations (NCD) Manual. CMS proposes that the evidence is adequate to conclude that screening for HIV infection for all individuals between the ages of 15 and 65 years, as is recommended with a grade of A by the United States Preventive Services Task Force (USPSTF), is reasonable and necessary for the early detection of HIV and is appropriate for individuals entitled to benefits under Part A or enrolled under Part B. CMS proposes to cover screening for HIV with the appropriate FDA approved laboratory tests and point of care tests, used consistent with FDA approved labeling and in compliance with CLIA regulations, when ordered by the beneficiary’s physician or practitioner within the context of a healthcare setting and performed by an eligible Medicare provider or supplier for these services. CMS is seeking comments on this proposed decision. They will respond to public comments in a final decision memorandum.